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General Questions about Star Behavioral Health and Roanoke TMS

What services do you offer at your practice?

Our main focus for treatment is interventional psychiatry – treating depression outside of medication only. We offer Spravato, TMS therapy and medication management. However, at this time our wait list for medication management is closed.

What insurances do you accept or are you in network with?

Currently, we are participating with most insurance plans. We accept commercial, Medicaid, and Medicare insurance. If you do not see your insurance listed below, please contact our billing office to verify we are in-network with your plan. We are willing to become in-network with any plan we do not currently have.

We are in network with –

All Anthem Plans
All Aetna Plans
All United Healthcare Plans*

*Unfortunately, at this time, we are not able to provide TMS therapy to patients insured by any United Healthcare or Optum plans.

Can I self-pay for any treatments not covered by my insurance, or if I am uninsured?

We welcome self-pay patients who are uninsured, and offer CareCredit as an option to paying for treatment.

Do I have to have a referral for treatment?

Yes, we do ask that one of your providers send us a referral for treatment. This can be your primary care provider, your counselor/therapist, or your psychiatrist.

What is the process to become a patient at your office?

Initially, we will gather some basic information from you and send you out our new patient forms to complete. The forms are lengthy, but the amount of information is necessary to qualify you for treatment through your insurance company. It is important that you provide as much detailed information as possible. We will also ask you to have one of your providers send us a referral for treatment.

I have a high out of pocket cost for treatment, do you have any options for payment plans?

We strive to make treatment as affordable as possible for all of our patients. We offer CareCredit, and are happy to discuss payment plans with all patients.

About Spravato

What is Spravato?

Spravato is a nasal spray medication that is used to treat depression in adults when other treatments haven’t worked. It contains a substance called esketamine, which is related to ketamine, a drug that has been used for anesthesia. Spravato works differently from most common antidepressants. It is given under medical supervision in a doctor’s office or a clinic because it can cause some strong side effects, and it needs to be monitored closely.

What is the difference between Spravato and ketamine?

Both Spravato and ketamine are used to treat depression, but Spravato is a nasal spray, and ketamine is given either as an intramuscular injection, or as an IV infusion. Spravato contains esketamine, a close relative of ketamine that is specifically targeted at treating depression. Spravato is approved by the FDA for treatment-resistant depression. Ketamine is used as “off-label” for depression, and is not usually covered by health insurance. Basically, Spravato is a specialized nasal spray for depression, while ketamine is a more general anesthetic also used “off-label” for depression.

What are the qualifications for Spravato treatment?

In order to be considered a candidate for Spravato treatment, a patient must be diagnosed with Major Depressive Disorder, have trialed at least two antidepressants, and be in therapy. The number and type of antidepressants depends on individual insurance plans and can vary.

Should I eat or drink before my treatment?

Nausea and vomiting are a possible side effect of treatment. We recommend that you have a light meal and be well hydrated before your appointment.

What should I bring to my treatment sessions?

Our goal is to make every patient as comfortable and relaxed as possible. We recommend headphones, a drink and a blanket.

How much does Spravato cost?

Spravato treatments are billed in two separate portions, the medication and the office visit. The medication is typically provided by a specialty pharmacy. For commercially insured patients, SpravatoWithMe offers a copay assistance program to make the cost of Spravato only $10 per treatment for the medication. Medicare plans vary greatly depending on the plan, the pharmacy benefit, and if the patient has any supplemental insurance. Medicaid will cover the cost of Spravato at 100%, with no out of pocket cost to the patient.

The second portion of the treatment is the office visit for the administration and monitoring for two hours. For commercially and Medicare insured patients, this cost is going to vary greatly depending on the plan benefits. Our office is considered a specialist, so the specialist benefits will apply.  For Medicaid, the cost is covered at 100%.

For the majority of patients who have any out of pocket cost, you will receive two separate bills. One from our office, and one from the pharmacy providing your medication. For specific billing questions, please reach out to our billing office.

Will I always need transportation home after my treatments?

Yes. Spravato and ketamine are controlled substances and do impair your ability to function for the remainder of the day of treatment. The FDA requires that you do not drive after your treatment. If you do not have transportation home, we will ask you to reschedule your appointment.

About TMS (transcranial magnetic stimulation)

What is TMS therapy?

TMS or transcranial magnetic stimulation, is a special device that creates magnetic fields. During the treatment, the device, called a helmet, is placed on the head near the forehead. The device sends a series of magnetic pulses, called trains, to the portion of the brain that affects mood control.

What should expect during treatment?

During a treatment session, you will feel tapping on your head, and hear clicking noises, but it shouldn’t be painful. There is no surgery or anesthesia required. After treatment, you can usually resume normal activities right away.

How often and how long are treatments?

For your first treatment, you should expect to be in the office around 1 hour. For the subsequent treatments, the sessions are 20 minutes each. A full course of treatment is 36 sessions. For the first  4 weeks, treatment is every day, Monday-Friday, then the treatments change to twice weekly for the remainder of the course.

Once I finish the full course of treatment, will I need to come back anymore?

Many patients benefit from “maintenance” TMS sessions which can be as often as weekly, biweekly, or monthly. These sessions are at the discretion of the patient and the TMS director.

What is the Brainsway difference?

The Brainsway  Deep TMS machine is the only machine FDA approved to treat Major Depressive Disorder, OCD, and smoking cessation. Brainsway has a patented H-coil design that is different from any other TMS machine on the market. The H-coil allows for a broader targeted area for treatment, as well as deeper brain stimulation.

How do I qualify for TMS treatment?

In order to qualify for TMS treatment, you must be diagnosed with Major Depressive Disorder, OCD, or be addicted to smoking. For Major Depressive Disorder and OCD, you must have trialed and failed at least two medications and be in psychotherapy. Each insurance varies in the specific requirements.

Is TMS therapy safe?

Yes. TMS therapy is generally safe and well-tolerated. The most common side effects include a mild headache and discomfort at the location of treatment.

Are there any long term side-effects to treatment?

No. There are no known long term side-effects to TMS therapy.

How much does TMS therapy cost?

The cost of TMS therapy can vary greatly depending on your specific insurance plan. Sometimes, the treatment is covered at 100%, sometimes a copay applies, and in some instances, you may have to meet your deductible and then pay your co-insurance. Our billing office is always happy to investigate your insurance benefits.

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